Skyline Happenings

Cognitive behavioral therapy for insomnia is considered the most effective treatment for people who continually struggle to fall or stay asleep.

By Christina Caron in the NYT

About one in four adults in the United States develops symptoms of insomnia each year. In most cases, these are short-lived, caused by things like stress or illness. But one in 10 adults is estimated to have chronic insomnia, which means difficulty falling or staying asleep at least three times a week for three months or longer.

Sleep deprivation doesn’t just create physical health problems, it can also harm our minds. A recent poll from the National Sleep Foundation, for example, found a link between poor sleep health and depressive symptoms. In addition, studies have shown that a lack of sleep can lead otherwise healthy people to experience anxiety and distress. Fortunately, there is a well-studied and proven treatment for insomnia that generally works in eight sessions or less: cognitive behavioral therapy for insomnia, or C.B.T.-I.

If you cannot find a provider, C.B.T.-I. instruction is easy to access online. Yet it is rarely the first thing people try, said Aric Prather, a sleep researcher at the University of California, San Francisco, who treats patients with insomnia.

Instead, they often turn to medication. According to a 2020 survey from the Centers for Disease Control, more than 8 percent of adults reported taking sleep medication every day or most days to help them fall or stay asleep.

Studies have found that C.B.T.-I. is as effective as using sleep medications in the short term and more effective in the long term. Clinical trial data suggests that as many as 80 percent of the people who try C.B.T.-I. see improvements in their sleep and most patients find relief in four to eight sessions, even if they have had insomnia for decades, said Philip Gehrman, the director of the Sleep, Neurobiology and Psychopathology lab at the University of Pennsylvania.

Sleep aids can carry risks, especially for older people, who may experience problems like falls, memory issues or confusion as a result of using the medication. C.B.T.-I., on the other hand, is considered safe for adults of any age. It can even be adapted for use in children.

What is C.B.T.-I.? (continued on Page 2)

CDC now recommends a second dose of the 2024-2025 COVID-19 vaccine for two groups:

• People 65 years and older and
• Everyone 6 months and older who are moderately or severely immunocompromised

The second dose of the 2024-2025 COVID-19 vaccine is recommended six months after the first dose. These groups remain at higher risk of severe COVID-19, and these updated recommendations help maximize their protection year-round. Data continue to confirm the importance of vaccination to protect those most at risk for severe outcomes of COVID-19. Also, data on COVID-19 vaccine effectiveness indicate that protection against COVID-19-associated emergency department and urgent care visits and hospitalization likely wanes by four to six months after vaccination. Fortunately, protection from admission to the intensive care unit, a sign of critical illness, lasts longer.

Additionally, data show that SARS-CoV-2, the virus that causes COVID-19, continues to circulate year-round, with peaks typically occurring in the winter and late summer.

CDC previously recommended that people who are moderately or severely immunocompromised may get additional doses of the COVID-19 vaccine, in consultation with a healthcare provider. Historically in years past, uptake of these additional doses for this group was low. ACIP voted to provide a clear recommendation for people who are six months or older and are moderately or severely immunocompromised to receive a second dose of 2024-2025 COVID-19 vaccine 6 months after their first dose.

These updated recommendations also allow for flexibility for additional doses (i.e., three or more) for people who are moderately or severely immunocompromised, in consultation with their healthcare provider (a strategy known as shared clinical decision making). These additional doses can be timed around immunosuppressive treatments, such as chemotherapy, after which some people may be at increased risk of severe COVID-19. These doses can also be timed around activities like travel or other life events, during which people may have increased risk of exposure to the virus that causes COVID-19.